Irish Medical Times article April 2015
Conference: Our hospitals are failing malnourished patients
AT LEAST one in four patients admitted to Irish hospitals shows signs of malnourishment, yet repeated calls to address this problem have been largely ignored, a conference organised by the Irish Society for Clinical Nutrition and Metabolism (lrSPEN) was told last month.
At the conference, both national and international experts expressed concern about the lack of progress made on this issue within Irish hospitals.
According to lrSPEN, more than one in four patients admitted to hospital show signs of malnutrition and have significant weight loss, with the majority of these patients losing even more weight before they leave.
An estimated 145,000 adults in Ireland are thought to be affected by malnutrition at any one time and the condition costs the health service €1.42 billion per year – largely because malnourished people are more likely to require hospital admission and require more care once they are in hospital. For example, malnourished patients stay
in hospital at least 30% longer than non-malnourished patients and they are three times more likely to develop an infection while in hospital. They are also up to four times more likely to develop pressure ulcers and are much more likely to be readmitted to hospital within 45 days.
The conference was told that nutrition screening needs to be conducted on patients when they are admitted to
hospital to identify those in need of supplementary feeding or further assessment by a dietitian. However, few hospitals in this country actually do this, which is contrary to Department of Health guidelines dating back to 2009.
“Our main focus has been on highlighting that poor nutrition is a common problem and that screening on the point of entry into hospital is the way to tackle the problem,” commented lrSPEN Chairman, Prof John Reynolds.
He also pointed out that many obese people are malnourished even though this may not be obvious.
“They may be fat but have lost a lot of their muscle mass.They have lost their ability to deal with their infections and are at higher risk of developing complications,” he said.
Meanwhile on a positive note, the conference was told about a new partnership between lrSPEN and the HSE, which will see the HSE commit to the introduction of a quality improvement programme that focuses on nutrition and hydration.
“We have been meeting with the HSE over the last two years and are very hopeful that we can now work with them to embed good nutritional care across our healthcare systems,” Prof Reynolds said.
“Nursing homes are now required to implement regular nutrition screening and care pathways that ensure they don’t become malnourished – this is something that should be done in hospitals as a matter of routine”.